Chronotype Differences in Lipid Profile and Atherogenic Risk Indices Among Patients with Bipolar Disorder

Abstract

Objective: Bipolar disorder (BD) is associated with a high cardiometabolic burden, influenced by factors such as lifestyle, medication, and circadian disruption. The study aimed to investigate the association between chronotype and cardiometabolic parameters in patients with BD. Materials and Methods: This cross-sectional study included 69 euthymic patients with BD I or II attending a community mental health center in Türkiye. Sociodemographic and clinical data were obtained alongside anthropometric measures, fasting blood samples, and psychometric assessments. Chronotype was determined using the Morningness–Eveningness Questionnaire, and patients were categorized into eveningness, intermediate, or morningness groups. Metabolic markers included body mass index, fasting glucose, triglycerides, total cholesterol, LDL-c, HDL-c, atherogenic coefficient, and Castelli risk indices. Results: Chronotype distribution was 27.5% (n=19) eveningness, 47.8% (n=33) intermediate, and 24.6% (n=17) morningness. Eveningness was associated with significantly lower total cholesterol and LDL-cholesterol levels, as well as more favorable atherogenic coefficient and Castelli risk indices compared with intermediate and morningness types (all FDR-corrected p<0.05). In ANCOVA models, chronotype remained significantly associated with LDL-cholesterol and all atherogenic indices after adjustment for demographic variables, BMI, smoking, antipsychotic treatment, and valproate use (all p<0.05). Higher MEQ scores (greater morningness) were positively correlated with LDL-cholesterol and atherogenic indices. Conclusion: Eveningness was linked to a healthier lipid profile in euthymic patients with bipolar disorder. This finding differs from most earlier studies and suggests that the effect of chronotype on metabolism may change depending on context. Considering chronotype could help personalize care and prevent metabolic problems in bipolar disorder.

Keywords

• Atherogenic indices
• bipolar disorder
• cardiometabolic risk
• chronotype
• circadian rhythm

Bipolar Bozukluğu Olan Hastalarda Lipid Profili ve Aterojenik Risk İndekslerinde Kronotip Farklılıkları

Abstract

Amaç: Bipolar bozukluk (BB), yaşam tarzı, ilaç kullanımı ve sirkadiyen ritim bozukluğu gibi faktörlerden etkilenen yüksek bir kardiyometabolik yük ile ilişkilidir. Çalışmanın amacı, BB tanılı hastalarda kronotip ile kardiyometabolik parametreler arasındaki ilişkiyi araştırmaktır. Materyal ve Metot: Bu kesitsel çalışmaya, Türkiye'de bir toplum ruh sağlığı merkezine başvuran 69 ötimik BB I veya II hastaları dahil edilmiştir. Sosyodemografik ve klinik veriler, antropometrik ölçümler, açlık kan örnekleri ve psikometrik değerlendirmelerle birlikte elde edilmiştir. Kronotip, Sabahçıl-Akşamcıl Anketi kullanılarak belirlenmiş ve hastalar akşamcı, ara form veya sabahçı gruplarına ayrılmıştır. Metabolik belirteçler arasında vücut kitle indeksi, açlık glukozu, trigliseritler, toplam kolesterol, LDL-kolesterol, HDL-kolesterol, aterojenik katsayı ve Castelli risk indeksleri yer almaktadır. Bulgular: Kronotip dağılımı %27,5 (n=19) akşamcıl, %47,8 (n=33) ara form ve %24,6 (n=17) sabahçıl olarak bulunmuştur. Akşamcıl tip, ara form ve sabahçıl tiplere kıyasla anlamlı derecede daha düşük toplam kolesterol ve LDL-kolesterol seviyeleri ile daha olumlu aterojenik katsayı ve Castelli risk indeksleri ile ilişkiliydi (tüm FDR düzeltilmiş p<0,05). ANCOVA modellerinde, demografik değişkenler, VKİ, sigara kullanımı, antipsikotik tedavi ve valproat kullanımı için ayarlama yapıldıktan sonra bile kronotip, LDL-kolesterol ve tüm aterojenik indekslerle anlamlı derecede ilişkili kaldı (tüm p<0,05). Daha yüksek MEQ puanları (daha fazla sabahçıl), LDL-kolesterol ve aterojenik indekslerle pozitif korelasyon gösterdi. Sonuç: Akşamcılık, bipolar bozukluğu olan ötimik hastalarda daha sağlıklı bir lipid profiliyle ilişkilendirilmiştir. Bu bulgu, önceki çalışmaların çoğundan farklıdır ve kronotipin metabolizma üzerindeki etkisinin bağlama göre değişebileceğini düşündürmektedir. Kronotipin dikkate alınması, bipolar bozuklukta bakımın kişiselleştirilmesine ve metabolik sorunların önlenmesine yardımcı olabilir.

Keywords

• Aterojenik indeksler
• bipolar bozukluk
• kardiyometabolik risk
• kronotip
• sirkadiyen ritim

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